• Richard Gardner, Taher Yousri, Fiona Holmes, Damian Clark, Phil Pollintine, Anthony W Miles, and Mark Jackson.
• Orthopaedic Department, Bristol Royal Infirmary and Centre for Orthopaedic Biomechanics, University of Bath, Bristol, United Kingdom. richardgardner@doctors.org.uk
• J Orthop Trauma. 2013 Apr 1; 27 (4): 212-6.

ObjectiveThe aim of this study is to determine whether a 2-hole locking plate has biomechanical advantages over conventional screw stabilization of the syndesmosis in this injury pattern.MethodsSix pairs of fresh-frozen human cadaver lower legs were prepared to simulate an unstable Maisonneuve fracture. Each limb was compared with its pair; the syndesmosis in one being stabilized with two 4.5-mm quadricortical cortical screws, the other a 2-hole locking plate with 3.2-mm locking screws. The limbs were then mounted on a servohydraulic testing rig and axially loaded to a peak load of 800N for 12000 cycles. Fibula shortening and diastasis were measured. Each limb was then externally rotated until failure occurred. Failure was defined as fracture of bone or metalwork, syndesmotic widening, or axial migration >2 mm.ResultsBoth constructs effectively stabilized the syndesmosis during the cyclical loading within 0.1 mm of movement. However, the locking plate group demonstrated greater resistance to torque compared with quadricortical screw fixation (40.6 Nm vs. 21.2 Nm, respectively, P value < 0.03).ConclusionA 2-hole locking plate (with 3.2-mm screws) provides significantly greater stability of the syndesmosis to torque when compared with 4.5-mm quadricortical fixation.

13 keywords...

hide…